Plague in Madagascar:overview of the 2014-2015 epidemic season.

Plague is an ancient disease of humans and animals, caused by the bacterium Yersinia pestis and transmitted by fleas. It continues to occur in many regions of the world: in the Far East, Central Asia, North Africa, subSaharan Africa, and North and South America. However, >90 % of cases of human plague are reported in Africa. Most cases result from flea bites and take the clinical form of bubonic plague, which although a severe infection cannot be transmitted from person to person. If diagnosed early, the disease responds favourably to routine specific antibiotic treatment. A significant proportion of bubonic cases develop spontaneously into pneumonic cases, which have a high case-fatality rate and are particularly contagious, and can cause epidemics that are difficult to control. This is why plague remains an international health challenge.